Excessive tearing after lower blepharoplasty

Sorry to hear about your experience. A second opinion can be very useful. Without an examination of your eyelids or knowing a bit more of your history prior to the surgery, one cannot give an opinion on your particular situation. Excessive tearing after eyelid surgery may be due to a number of factors. One may be Dry Eye. That sounds a bit contradictory, but eyelids produce two types of tears, lubricating and tears of irritation or in response to emotion. When there is a deficiency of lubricating tears, one response is to "cry". Using an Over The Counter tear replacement eye drop can help. Second may be structural - either a blocked duct or ectropian, a pulling down of the lid. After eyelid surgery the lower eyelid may be stiff and tight. Massage in an upward direction with or without taping may get one through until the tissues have had a chance to soften and relax.

It is not possible to diagnose your problem without a personal exam but your symptom is very common after lower lid surgery and usually resolves with healing in a few weeks. Your observation of the lower lid droop suggests that your lid closure may be incomplete and often this resolves as the eyelid muscles recover and the swelling resolves and the tissues become supple (weeks or even months).

Supporting the lower lid with tape, use of eye drops and ointment (at night during sleep) or even a temporary suture at the corner of the eyelids or patching the lid closed may help reduce the tearing during the recovery. Occasionally additional surgery is needed to release the internal scar with or without an additional skin graft if the skin is deficient and/or create more upward support for or re-positioning of the weakened lid, especially in patients over 60 years old.

Dr. C. Dennis Bucko
Board Certified Plastic Surgeon

I am sorry to hear about your tearing issue. This can happen after a lower blepharoplasty. If the lower eye is slightly drooping away from the eye, it can cause swelling and tearing. It may be a good idea to cover your eye with a patch to give your eye time to rest. I also recommend massage with your finger along the lower eye lid to help diminish the scar tissue that is forming and it will also help improve the drooping. Please keep us posted on your recovery!

In general, lower eyelid blepharoplasty can be more tricky than upper eyelid surgery because when treating many of the problems associated with aging lower lids it involves skin and soft tissue tightening of structures that need support so that the lid functions normally. To potentially complicate things further, the lower lid position and shape is very influenced by the adjacent, heavy cheek below. It is very important to not only assess this anatomy properly but to then perform the appropriate procedure(s) so that the function of the lower lid is not disturbed. The main purpose of the lower lid is to catch the constant flow of tears and channel it to the punctum (openings to tear ducts) so that the tears naturally drain into the nasal cavity. When there is a disruption in this normal anatomy excess, actual, tearing occurs. This may be your problem. The good news is that often times it will resolve as the healing process continues and there is less pulling on the lower lid. If it does not resolve, you may need a secondary procedure to give support to the lax lower lid, like a canthoplasty. Sometimes a cheek lift may be necessary to help descent of the lower lid that is caused by the weight of the cheek. I would discuss this further with your Plastic surgeon but if you are still not confident with the answers you are getting than get a second opinion.